of the pathogen. The faster the pathogen is detected, the faster the outbreak can be controlled. The chapter continues with a description of several novel approaches for rapid early detection, including the most promising assay, real-time fluorescent polymerase chain reaction, as well as some other techniques: antigen capture/enzyme-linked immunosorbent assay, mass spectrometry, and restriction fragment length polymorphisms. The development of these techniques for detection will enable a quick diagnosis of the agent and faster development of vaccines.

The chapter concludes with mathematical modeling of pandemic preparedness plans, showing the consequences on health economic outcomes of possible intervention strategies. This modeling helps to determine the costs and benefits of different strategies and gauges the public health benefits of optimized preparedness.


Suzanne L. Epstein1,2

Office of Cellular, Tissue and Gene Therapies, Center for Biologics Evaluation and Research, Food and Drug Administration

Reprinted with permission, from Epstein (2003), published in Expert Review of Anti-infective Therapy, Copyright 2003 Future Drugs

Influenza has circulated among humans for centuries and kills more people than many newly emerging diseases. The present methods for control of influenza are not adequate, especially for dealing with a pandemic. In the face of a rapidly spreading outbreak, a race to isolate the virus and prepare a vaccine would probably not succeed in time to avoid great losses. Thus, additional anti-infection strategies are needed. Broad cross-protection against widely divergent influenza A subtypes is readily achieved in animals by several means of immunization. How does cross-protection work in animals, and can we apply what we have learned about it to induce broad cross-protection in humans?


Suzanne L. Epstein, PhD, Chief, Laboratory of Immunology and Developmental Biology, Division of Cellular and Gene Therapies, HFM-730, Office of Cellular, Tissue and Gene Therapies, Center for Biologics Evaluation and Research, Food and Drug Administration, 301–827–0450, fax: 301–827–0449, e-mail: epsteins@cber.fda.gov.


SLE acknowledges grant support from the National Vaccine Program. I thank Steven Bauer, Ira Berkower, Mark Tompkins, Zi-Shan Zhao and Chia-Yun Lo for critical review of various versions of the manuscript.

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